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中华卫生应急电子杂志 ›› 2020, Vol. 06 ›› Issue (04) : 229 -232. doi: 10.3877/cma.j.issn.2095-9133.2020.04.007

所属专题: 文献

论著

术前虚弱对老年膝髋关节置换术患者术后并发症的影响
范云霞1, 戴雷1, 高炟鹏2, 张晶云1, 谷书馨1, 李国民3,()   
  1. 1. 213200 江苏常州,江苏大学附属金坛医院麻醉科
    2. 210000 江苏南京,南京医科大学附属金陵临床医学院麻醉科
    3. 213200 江苏常州,江苏大学附属金坛医院重症医学科
  • 收稿日期:2020-03-21 出版日期:2020-08-18
  • 通信作者: 李国民
  • 基金资助:
    国家自然科学基金(81772126)

Effects of preoperative frailty on postoperative complications in elderly patients undergoing knee and hip surgeries

Yunxia Fan1, Lei Dai1, Dapeng Gao2, Jingyun Zhang1, Shuxin Gu1, Guomin Li3,()   

  1. 1. Department of Anesthesiology, Jintan Hospital, Jiangsu University, Changzhou 213200, China
    2. Department of Anesthesiology, General Hospital of Eastern Theater Command, NanJing 210000, China
    3. Department of Anesthesiology and Intensive Care Unit, Jintan Hospital, Jiangsu University, Changzhou 213200, China
  • Received:2020-03-21 Published:2020-08-18
  • Corresponding author: Guomin Li
  • About author:
    Corresponding author: Li Guomin, Email:
引用本文:

范云霞, 戴雷, 高炟鹏, 张晶云, 谷书馨, 李国民. 术前虚弱对老年膝髋关节置换术患者术后并发症的影响[J/OL]. 中华卫生应急电子杂志, 2020, 06(04): 229-232.

Yunxia Fan, Lei Dai, Dapeng Gao, Jingyun Zhang, Shuxin Gu, Guomin Li. Effects of preoperative frailty on postoperative complications in elderly patients undergoing knee and hip surgeries[J/OL]. Chinese Journal of Hygiene Rescue(Electronic Edition), 2020, 06(04): 229-232.

目的

探讨术前虚弱对老年患者膝髋关节置换术术后并发症的影响。

方法

以2016年6月至2019年9月常州市金坛区人民医院骨科收治的306例行膝髋关节置换术的老年患者为研究对象进行前瞻性队列研究,其中男性103例,女性203例;年龄65~89岁,平均(74.5±6.2)岁。术前根据改良虚弱指数(mFI)评估结果将患者分为虚弱组(mFI≥3分)与非虚弱组(mFI<3分)。比较两组患者术前的临床资料[身体质量指数(BMI)、美国麻醉医师协会(ASA)分级]、术中情况(手术时间、失血量)、术后并发症发生率以及预后(住院时间、30 d再入院率)。并绘制mFI预测老年患者术后并发症发生的ROC曲线。

结果

本研究纳入研究对象的术前虚弱发生率为34.3%(105/306)。虚弱组患者的术后并发症发生率为35.2%(37/105),高于非虚弱组[16.9%(34/201)],差异有统计学意义(P<0.05)。术前虚弱预测老年膝髋关节置换术患者术后并发症发生的ROC曲线下面积为0.87,敏感度为63%,特异度为89%。

结论

术前虚弱显著增加老年膝髋关节置换术患者发生术后并发症。

Objective

To explore the association between preoperative frailty and postoperative complications in elderly patients undergoing knee and hip surgeries.

Methods

Three-hundred and six elderly (≥65 years) patients undergoing knee or hip surgeries were included and a prospective cohort study was performed in General Hospital of Eastern Theater Command from June 2016 to September 2019. The patients included 103 males, 203 females, aged 65-89 years, with mean age 74.5± 6.2 years. According to preoperative frailty assessment by modified frailty index (mFI), patients were divided into frail and non-frail groups. Baseline characteristics [Body mass index (BMI), ASA classification, intraoperative conditions (surgery time, blood loss), postoperative complication incidence and outcome (hospital stay, 30-day readmission)] and ROC curve were compared between the two groups.

Results

This study showed that 34.3% (105/306)of patients were categorized as the frail group. The incidence of postoperative complications was 35.2% (37/105), which was significantly higher than non-frail group [16.9% (34/201)] (P<0.05). The area under ROC curve of preoperative frailty by area under ROC curve to predict postoperative complications was 0.87, with a sensitivity of 63% and specificity of 89%.

Conclusion

Preoperative frailty significantly increases postoperative complication incidence in elderly patients undergoing knee and hip surgeries.

表1 两组老年膝髋关节置换术患者的基线资料[例(%)]
表2 两组老年膝髋关节置换术患者临床资料比较[例(%)]
图1 术前虚弱预测老年膝髋关节置换术患者发生术后并发症的ROC曲线
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